纤维支气管镜吸痰在慢阻肺呼吸衰竭患者中的应用分析  

Analysis of application of fiberoptic bronchoscopy sputum suction in COPD patients with respiratory failure

作　　者：唐颖[1] TANG Ying(Daqing Longnan Hospital in Heilongjiang Province(the Fifth Affiliated Hospital of Qiqihar Medical College),Daqing163453,China)

机构地区：[1]黑龙江省大庆龙南医院(齐齐哈尔医学院第五附属医院),黑龙江大庆163453

出　　处：《中国现代医生》2020年第21期113-115,119,共4页China Modern Doctor

摘　　要：目的探讨纤维支气管镜吸痰应用在慢阻肺呼吸衰竭中的效果及意义。方法研究时间轴设置为2019年2月~2020年2月,纳入我院共80例慢阻肺呼吸衰竭患者,将其作为此次研究的人群。以随机数字表法均等分组,依次设为对照组(n=40)以及观察组(n=40),前者在喉镜引导下经口腔气管插管以及辅助呼吸;后者在纤维支气管引导下经鼻腔气管插管,并予以吸痰、肺泡灌洗、辅助呼吸。评价两组患者痰培养阳性率、呼吸衰竭纠正时间、有创通气时间、PIC出现时间、一次性插管成功率、并发症率、平均插管时间。结果观察组痰培养阳性率(97.5%)较对照组(75.0%)更高,观察组呼吸衰竭纠正时间、有创通气时间、PIC出现时间依次为(10.44±1.21)h、(5.02±0.16)h、(5.30±1.02)d,较对照组(18.20±1.62)h、(10.22±1.51)h、(10.60±1.56)d更短,组间比较差异有统计学意义(P<0.05)。观察组一次性插管成功率(95%)高于对照组(80%),并发症率(5%)低于对照组(20%),平均插管时间(4.12±1.15)min短于对照组(7.81±1.21)min,组间比较差异有统计学意义(P<0.05)。结论应用纤维支气管镜对慢阻肺呼吸衰竭患者进行吸痰,对患者呼吸功能的改善以及病情抢救有积极影响,对预后恢复有重要意义。Objective To explore the effect and significance of fiberoptic bronchoscopy sputum suction in the treatment of COPD and respiratory failure.Methods A total of 80 patients with COPD in our hospital from February 2019 to February 2020 were included as the population of this study.They were divided into a control group(n=40)and an observation group(n=40)by random number table method.The control group was given oral tracheal intubation under the guidance of laryngoscope and assisted breathing.The observation group was given nasal tracheal intubation under the guidance of fiberoptic bronchoscopy,and sputum suction,alveolar lavage,assisted breathing.The positive rate of sputum culture,the time to correct respiratory failure,the time of invasive ventilation,the time of PIC appearance,the success rate of one-time intubation,the rate of complications,and the average time of intubation were evaluated.Results The positive rate of sputum culture in the observation group(97.5%)was higher than that in the control group(75.0%).The respiratory failure correction time,invasive ventilation time,and PIC appearance time of the observation group were(10.44±1.21)h,(5.02±0.16)h,(5.30±1.02)d,shorter than(18.20±1.62)h,(10.22±1.51)h,(10.60±1.56)d of the control group,and the difference between the groups was statistically significant(P<0.05).The observation group had a one-time intubation success rate(95%)higher than the control group(80%).The complication rate(5%)of the observation group was lower than that of the control group(20%).The average intubation time(4.12±1.15)min in the observation group was shorter than that of the control group(7.81±1.21)min.The difference between the groups was statistically significant(P<0.05).Conclusion The application of fiberoptic bronchoscopy to sputum suction in patients with COPD has a positive impact on the improvement of patients'respiratory function and the rescue of their condition,and it is very important for the prognosis recovery.

关 键 词：纤维支气管镜 吸痰 慢阻肺 呼吸衰竭 呼吸功能 

分 类 号：R563.9[医药卫生—呼吸系统] R563.8[医药卫生—内科学]